Is this the dementia or the infection or a combination of the both?

Thank You,
That's exactly what we are doing. Hard to find base line with infection. As of today, well yesterday she was great abit confused but otherwise alot of snap more her old self. Today, great early this morning now asking about going home ( she is home) who are the boys ( there are no boys) ect.. We will just have to see how the day progresses. Doc/home health care kept informed at all times, I also take extensive notes jotting down BP. BS and if any sudden changes in behavior happen along.

I have found personally in my experience that the combination of any kind of infections including a simple cold, a UTI, the superbug she picked up a few months ago at the hospital while treating a UTI, or anything else that messes with her body, has caused her to act very confused, lost and even angry. For that reason I dread it when she's sick. When she has a cold she can either be very angry refusing food or drink or to get changed. Then she can also be crying, and asking for her mom just as I have felt in the past while sick. I think the body when it's fighting against an illness can only do so much. I'm thinking you are wanting reassurance that it will get better and she will go back to the state she was in before the sickness. I always live like that is the case. I tend to think anything is temporarily. It helps if I think that way. So if she has a UTi and honestly I'm not sure if its just a new stage we have gotten into or the UTI, I think like it's just UTI symptoms and if they aren't, I've gotten used to the change so it's not as harmful as it would have been if I had been realizing it was a new stage. Caring for loved ones with dementia can be so tough as I have found out. There is no right or wrong answers a lot of times and that's because people are individuals. My instinct tells me the sickness is making the dementia show its true colors and that once shes' feeling better she might get back into some kind of state that she was in before. Take one day at a time and find a way to deal with this new her.

Well an update, newest UA shows infection has changed to pseudomonas ( current antibiotic works on it as well), so we got yet one more battling around, at least this one is not a "Super Bug". She seems to be coming around and we think we are now meeting new post stroke dementia grannie. Old dementia grannie was a rough one.... couple black eyes to prove it, current grannie is nice, abit forgetful, abit clingy, not super coordinated but getting back on a sleep schedule and not trying to knock your block off. Physical therapy at home is moving right along, will she ever walk again more than likely not, but we do have high hopes for assisted transfers without the hoyer lift. Only obsessions lately have been with the call button and not Pooh thank god,lol. Hopeful we are now meeting Base line grannie.. for this stage at least. Shane thank you, It's just me and my husband ( her grandson) but things are looking up. My high point was yesterday.. She hit her call button wanted to see how it worked. I showed her yet again and went off to the kitchen.. she called me back and said Summer take me home.... I told her we are home grannie.. showed her pictures on the wall ect.. sat down beside her and we just talked.. explained she's not crazy she has an infection. Then we discussed if she remembered she has dementia and why, she said yes. those damn strokes keep eatting my brain! I said well kinda but no your not crazy it's just the infection makes the dementia worse so you get abit more confused. She asked me why I was still taking care of her, my response you took care of alot of folks, 5 kids, your grandkids and now it's time for someone to take care of you. She asked me if I was going to leave her and I said nope not going to happen ever, she got very clear eyed and said Thank you.. I damn near burst into tears.. since 2009 1st time she has ever told me thank you. Hurt but felt so good at the same time, hurt as in I'm very angry her kids don't help or visit but good because we ( my husband and I) can hopefully give her a good life and the dignity she deserves.

It sounds like you have the situation under control thanks to your ability to pick up on her treatment to assure she gets the correct meds. Good job! Also the transition from the hospital back home can be adding to her confusion and insomnia- no one ever gets sleep in a hospital and she is probably exhausted as well. But thanks to your excellent care it appears she is slowly bouncing back.
Difficult decision about the blood thinners vs her recent strokes. Often the patient is put on Lovenox subcutaneously for a while and then maybe a baby aspirin but it sounds like her PCP is on top of this.
Glad she is eating! She is very fornunate to have you and the rest of your family. Good luck!

Not sure why the mod's removed the name of the bug but she is now ( with the help of more meds and antibiotics) sleeping,  well did last night, eating if I hand feed her ( we bought stage 2 baby food told her it was food made for folks that have a hard time swallowing after strokes) and drinking her boosts! Also bought a toddler sippy cup, told her bike riders use them so the water won't spill she is using it like a champ. Still very hazy and weak but at least sleeping, not screaming in pain and eating!

OK I'm confused, seems the moderators have removed the name of the super-bug?
When I saw the way they were trying to send her home I immediately assumed she was gravely ill and the infection had overwhelmed her, not that they were a bunch of incompetent boobs. It sounds as though you are getting help and that she can recover from this, hopefully when she stabilizes physically her mind will stabilize as well.

She has a CRE ( klebsiella pneumoniae) not a VRE, Not ecoli, nurse just left, pulled another urinalysis, full blood panel, mobility wise she is bed ridden, eating has been an issue, basically have to trick or bully her into eating with at least 3-4 boost per day. She is on blood thinner because strokes 1, 2 and 3 where clots, stroke 4 was lack of blood flow due to BP dropping. And yes.... we know there is no IV coumadin but I have the written script here that they tried to send her home on, and yeah they tried to call it into the pharmacy.. as I said the rehab majorly dropped the ball.

Hope all goes well please return to the ER if she presents with worsing symptoms

The RN can recommend hospice is it necessary at this point ? Does she need speech therapy for swallowing issues ? What is her mobility? Is she eating ?

I'm glad she is being followed by PT and OT and a home RN they will monitor her and make sure she is stable and is moving

VRE is vancomycin resistant enterococcus which is a gram neg rod caused by ecoli which is usually fecal caused by not wiping correctly and she must of received vancomycin iv in the hospital... that caused the VRE which is pretty common these days ...esp in the elderly ...now that can be caused by a UTI the gram neg rods which made her confused ,,she needs to probably go back and get some iv antibotics different than the vancomycin...there is no iv Coumadin ,,,now there's subcutaneous heparin ..what kind of stroke did she have if it was hemorrhagic she shouldn't be on blood thinners .... ecoli is treatable ..if it dosent get better she needs to be admitted through the ER

It is in her urine presenting as UTI, not in her bloodstream, not causing pneumonia, Meningitis, oxygen levels great. Lungs clear. And no it really doesnt make a difference on whats causing it, just would be piece of mind to know if it's the infection or a new stage of the dementia. Yeah superbug, had 2 labs run a UIA to see what exactly we where dealing with as the hospital told us it was Ecoli (VRE) and it's not It's klebsiella pneumoniae (CRE)... Just so frigging frustrated at hospital, rehab Incompetence.... And no one has suggested hospice yet. We do have a nurse 2 times a week, doctor's office visits every 2 weeks, PT 2 times a week ,OT 2 x aweek  and a bathing assistant 2 X's a week. I should add she also had her 4th stroke Dec 17th ( while in rehab).

Does it make any difference what's causing it? I don't mean that to sound antagonistic, just that unless knowing the answer will change anything about your grandmother's care, I'm not sure it's worth using up any time or effort to find out?

It's probably both, though - not likely that one wouldn't have any influence on the other. Plus, did the primary doctor check her O2 levels? With the pneumonia, she might be struggling a bit there too, perhaps.

But whatever is going on, I hope she settles down very soon once the antibiotics kick in. Her being frightened and wakeful must be miserable for everyone there, I'm so sorry. Take care of yourself, too.

I had to look that up as I was unfamiliar with it... great, another superbug we can acquire in the hospital. In what way has the bacterium affected her, from my reading it can attack several areas of the body?
I think perhaps it doesn't really matter, it really sounds to me as though they have given up on her and are sending her home for her final days. Are they being honest about that, what are they telling you? This is a terrible thing to be dealing with unsupported and without on call medical assistance, has anyone suggested hospice?